SEC. 101. Short Title.
This title may be cited as the “Conceding Our Veterans’ Exposure Now and Necessitating Training Act of 2022” or the “COVENANT Act of 2022”.
Title I — Expansion of Health Care Eligibility
TITLE I Expansion of Health Care Eligibility
Subtitle A Toxic-exposed Veterans
SEC. 102. Definitions Relating to Toxic-Exposed Veterans.
In General.— Section 1710(a)(2)(F) is amended by striking “ who was exposed to a toxic substance, radiation, or other conditions, as provided in subsection (e)” and inserting “ who is a toxic-exposed veteran, in accordance with subsection (e)”.
Definitions of Toxic Exposure and Toxic-exposed Veteran.— Section 101 is amended by adding at the end the following new paragraphs:
“(37) The term ‘toxic exposure’ includes the following:
“(A) A toxic exposure risk activity, as defined in section 1710(e)(4) of this title.
“(B) An exposure to a substance, chemical, or airborne hazard identified in the list under section 1119(b)(2) of this title.
“(38) The term ‘toxic-exposed veteran’ means any veteran described in section 1710(e)(1) of this title.”
Definition of Toxic Exposure Risk Activity.— Section 1710(e)(4) is amended by adding at the end the following new subparagraph:
“(C) The term ‘toxic exposure risk activity’ means any activity—
“(i) that requires a corresponding entry in an exposure tracking record system (as defined in section 1119(c) of this title) for the veteran who carried out the activity; or
“(ii) that the Secretary determines qualifies for purposes of this subsection when taking into account what is reasonably prudent to protect the health of veterans.”
SEC. 103. Expansion of Health Care for Specific Categories of Toxic-Exposed Veterans and Veterans Supporting Certain Overseas Contingency Operations.
In General.—
Expansion.— Subsection (e) of section 1710, as amended by section 102(c), is further amended—
in paragraph (1), by adding at the end the following new subparagraphs:
“(G) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who participated in a toxic exposure risk activity while serving on active duty, active duty for training, or inactive duty training is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
“(H) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a covered veteran (as defined in section 1119(c) of this title) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
“(I)
(i) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who deployed in support of a contingency operation specified in clause (ii) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
“(ii) A contingency operation specified in this clause is any of the following:
“(I) Operation Enduring Freedom.
“(II) Operation Freedom’s Sentinel.
“(III) Operation Iraqi Freedom.
“(IV) Operation New Dawn.
“(V) Operation Inherent Resolve.
“(VI) Resolute Support Mission.”
; and
in paragraph (2)(B)—
by striking “ or (F)” and inserting “ (F), (G), (H), or (I)”; and
by striking “ service or testing” and inserting “ service, testing, or activity”.
Phase in.— Such subsection is further amended by adding at the end the following new paragraph:
“(6)
(A) The Secretary shall determine the dates in subparagraphs (G), (H), and (I) of paragraph (1) as follows:
“(i) October 1, 2024, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on August 2, 1990, and ending on September 11, 2001.
“(ii) October 1, 2026, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on September 12, 2001, and ending on December 31, 2006.
“(iii) October 1, 2028, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2007, and ending on December 31, 2012.
“(iv) October 1, 2030, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2013, and ending on December 31, 2018.
“(v) October 1, 2032, with respect to a veteran described in such subparagraph (I).
“(B)
(i) The Secretary may modify a date specified in subparagraph (A) to an earlier date, as the Secretary determines appropriate based on the number of veterans receiving hospital care, medical services, and nursing home care under subparagraphs (G), (H), and (I) of paragraph (1) and the resources available to the Secretary.
“(ii) If the Secretary determines to modify a date under clause (i), the Secretary shall—
“(I) notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives of the proposed modification; and
“(II) publish such modified date in the Federal Register.”
Outreach Plans.— With respect to each of clauses (i) through (v) of section 1710(e)(6)(A) of title 38, United States Code (as added by subsection (a)(2)), not later than 180 days before the date specified in the clause (including a date modified pursuant to such section), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a plan to conduct outreach to the veterans described in the clause to notify such veterans of their eligibility for hospital care, medical services, or nursing home care under subparagraph (G), (H), or (I), of section 1710(e)(1) of such title, as the case may be.
SEC. 104. Assessments of Implementation and Operation.
Initial Resource Assessment and Report.— Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall—
complete an assessment to determine—
the personnel and material resources necessary to implement section 103 (including the amendments made by such section); and
the total number of covered veterans, as such term is defined in section 1119(c) of title 38, United States Code (as added by section 302), who receive hospital care or medical services furnished by the Secretary under chapter 17 of such title, disaggregated by priority group specified in section 1705(a) of such title; and
submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report containing the findings of the assessment completed under paragraph (1), including a specific determination as to whether the Department has the personnel and material resources necessary to implement section 103.
Information Systems.— Not later than October 1, 2024, the Secretary shall establish information systems to assess the implementation of section 103, including the amendments made by such section, and use the results of assessments under such systems to inform the reports under subsection (c).
Annual Reports.—
Reports.— Not later than October 1, 2025, and on an annual basis thereafter until October 1, 2033, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the following:
The effect of the implementation of, and the provision and management of care under, section 103 (including the amendments made by such section) on the demand by veterans described in subparagraphs (G), (H), and (I) of section 1710(e)(1) of title 38, United States Code (as added by such section 103) for health care services furnished by the Secretary.
Any differing patterns of demand for health care services by such veterans, disaggregated by factors such as the relative distance of the veteran from medical facilities of the Department and whether the veteran had previously received hospital care or medical services furnished by the Secretary under chapter 17 of such title.
The extent to which the Secretary has met such demand.
Any changes, during the year covered by the report, in the delivery patterns of health care furnished by the Secretary under chapter 17 of such title, and the fiscal impact of such changes.
Matters.— Each report under paragraph (1) shall include, with respect to the year covered by the report, detailed information on the following:
The total number of veterans enrolled in the patient enrollment system who, during such year, received hospital care or medical services furnished by the Secretary under chapter 17 of title 38, United States Code.
Of the veterans specified in subparagraph (A), the number of such veterans who, during the preceding three fiscal years, had not received such care or services.
With respect to the veterans specified in subparagraph (B), the cost of providing health care to such veterans during the year covered by the report, shown in total and disaggregated by—
the level of care; and
whether the care was provided through the Veterans Community Care Program.
With respect to the number of veterans described in subparagraphs (G), (H), and (I) of section 1710(e)(1) of title 38, United States Code (as added by section 103), the following (shown in total and disaggregated by medical facility of the Department, as applicable):
The number of such veterans who, during the year covered by the report, enrolled in the patient enrollment system.
The number of such veterans who applied for, but were denied, such enrollment.
The number of such veterans who were denied hospital care or a medical service furnished by the Secretary that was considered to be medically necessary but not of an emergency nature.
The numbers and characteristics of, and the type and extent of health care furnished by the Secretary to, veterans enrolled in the patient enrollment system (shown in total and disaggregated by medical facility of the Department).
The numbers and characteristics of, and the type and extent of health care furnished by the Secretary to, veterans not enrolled in the patient enrollment system (disaggregated by each class of eligibility for care under section 1710 of title 38, United States Code, and further shown as a total per class and disaggregated by medical facility of the Department).
The specific fiscal impact (shown in total and disaggregated by geographic health care delivery areas) of changes in the delivery patterns of health care furnished by the Secretary under chapter 17 of such title as a result of the implementation of section 103 (including the amendments made by such section).
Definitions.— In this section:
Patient enrollment system.— The term “patient enrollment system” means the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code.
Veterans community care program.— The term “Veterans Community Care Program” means the program established under section 1703 of title 38, United States Code.
Subtitle B Certain Veterans of Combat Service and Other Matters
SEC. 111. Expansion of Period of Eligibility for Health Care for Certain Veterans of Combat Service.
Expanded Period.— Section 1710(e)(3) is amended—
in subparagraph (A)—
by striking “ January 27, 2003” and inserting “ September 11, 2001”; and
by striking “ five-year period” and inserting “ 10-year period”;
by amending subparagraph (B) to read as follows:
“(B) With respect to a veteran described in paragraph (1)(D) who was discharged or released from the active military, naval, air, or space service after September 11, 2001, and before October 1, 2013, but did not enroll to receive such hospital care, medical services, or nursing home care under such paragraph pursuant to subparagraph (A) before October 1, 2022, the one-year period beginning on October 1, 2022.”
; and
by striking subparagraph (C).
Clarification of Coverage.— Section 1710(e)(1)(D) is amended by inserting after “ Persian Gulf War” the following: “ (including any veteran who, in connection with service during such period, received the Armed Forces Expeditionary Medal, Service Specific Expeditionary Medal, Combat Era Specific Expeditionary Medal, Campaign Specific Medal, or any other combat theater award established by a Federal statute or an Executive order)”.
Outreach Plan.— Not later than December 1, 2022, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a plan to conduct outreach to veterans described in subparagraph (B) of section 1710(e)(3) of title 38, United States Code, as amended by subsection (a)(2), to notify such veterans of their eligibility for hospital care, medical services, or nursing home care pursuant to such subparagraph.
Report on Enrollments.— Not later than January 30, 2024, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report identifying, with respect to the one-year period beginning on October 1, 2022, the number of veterans described in section 1710(e)(3)(B) of title 38, United States Code, as amended by subsection (a)(2), who, during such period, enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of such title.
Effective Date.— This section and the amendments made by this section shall take effect on October 1, 2022.